Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies


Por: Carrillo-Larco, Rodrigo M., Stern, Dalia, Hambleton, Ian R., Hennis, Anselm, Cesare M.D., Lotufo P., Ferreccio C., Irazola V., Perel, Pablo, Gregg, Edward W., Miranda, J. Jaime, Ezzati, Majid, Danaei, Goodarz, Aguilar-Salinas, Carlos A., Alvarez-Vaz, Ramon, Amadio, Marselle B., Baccino, Cecilia, Bambs, Claudia, Bastos, Joao Luiz, Beckles, Gloria, Bernabe-Ortiz, Antonio, Bernardo C.D., Bloch, V, Katia, Blumel, Juan E., Boggia, Jose G., Borges, Pollyanna K., Bravo, Miguel, Brenes-Camacho, Gilbert, Carbajal, Horacio A., Rascon M.S.C., Ceballos, Blanca H., Colpani, Veronica, Cooper, Jackie A., Cortes, Sandra, Cortes-Valencia, Adrian, Cunha, Roberto S., D'Orsi, Eleonora, Dow, William H., Espeche, Walter G., Fuchs, Flavio D., Fuchs, Sandra C., Gimeno, Suely G. A., Gomez-Velasco, Donaji, Gonzalez-Chica, David A., Gonzalez-Villalpando, Clicerio, Gonzalez-Villalpando M.-E., Grazioli, Gonzalo, Guerra, Ricardo O., Gutierrez, Laura, Herkenhoff, Fernando L., Horimoto, Andrea R. V. R., Huidobro, Andrea, Koch, Elard, Lajous, Martin, Lima-Costa, Maria Fernanda, Lopez-Ridaura, Ruy, Maciel, Alvaro C. C., Manrique-Espinoza, Betty S., Marques, Larissa P., Mill, Jose G., Moreira, Leila B., Muñoz O.M., Ono, Lariane M., Oppermann, Karen, Paiva, Karina M., Peixoto, V, Sergio, Pereira, Alexandre C., Peres, Karen G., Peres, Marco A., Ramirez-Palacios, Paula, Rech, Cassiano R., Rivera-Paredez, Berenice, Rodriguez, I, Nohora, Rojas-Martinez, Rosalba, Rosero-Bixby, Luis, Rubinstein, Adolfo, Ruiz-Morales, Alvaro, Salazar, Martin R., Salinas-Rodriguez, Aaron, Salmeron, Jorge, Sanchez, Ramon A., Silva, Nelson A. S., Silva, Thiago L. N., Smeeth, Liam, Spritzer, Poli M., Tartaglione, Fiorella, Tartaglione, Jorge, Velazquez-Cruz, Rafael

Publicada: 1 dic 2021
Resumen:
Background: Estimates of the burden of cardio-metabolic risk factors in Latin America and the Caribbean (LAC) rely on relative risks (RRs) from non-LAC countries. Whether these RRs apply to LAC remains un-known. Methods: We pooled LAC cohorts. We estimated RRs per unit of exposure to body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and non-HDL cholesterol on fatal (31 cohorts, n = 168,287) and non-fatal (13 cohorts, n = 27,554) cardiovascular diseases, adjusting for regression dilution bias. We used these RRs and national data on mean risk factor levels to estimate the number of cardiovascular deaths attributable to non-optimal levels of each risk factor. Results: Our RRs for SBP, FPG and TC were like those observed in cohorts conducted in high-income countries; however, for BMI, our RRs were consistently smaller in people below 75 years of age. Across risk factors, we observed smaller RRs among older ages. Non-optimal SBP was responsible for the largest number of attributable cardiovascular deaths ranging from 38 per 100,000 women and 54 men in Peru, to 261 (Dominica, women) and 282 (Guyana, men). For non-HDL cholesterol, the lowest attributable rate was for women in Peru (21) and men in Guatemala (25), and the largest in men (158) and women (142) from Guyana. Interpretation: RRs for BMI from studies conducted in high-income countries may overestimate disease burden metrics in LAC; conversely, RRs for SBP, FPG and TC from LAC cohorts are similar to those esti -mated from cohorts in high-income countries. Funding: Wellcome Trust (214185/Z/18/Z) (c) 2021 The Author(s). Published by Elsevier Ltd.

Filiaciones:
Carrillo-Larco, Rodrigo M.:
 Imperial College London, United Kingdom

Stern, Dalia:
 National Institute of Public Health, Mexico

Hambleton, Ian R.:
 The University of the West Indies, Barbados

Hennis, Anselm:
 Pan American Health Organization, United States

Cesare M.D.:
 Middlesex University, United Kingdom

Lotufo P.:
 University of São Paulo, Brazil

Ferreccio C.:
 Pontificia Universidad Católica de Chile, Chile

Irazola V.:
 Institute for Clinical Effectiveness and Health Policy, Argentina

Perel, Pablo:
 London School of Hygiene and Tropical Medicine, United Kingdom

Gregg, Edward W.:
 Imperial College London, United Kingdom

Miranda, J. Jaime:
 Universidad Peruana Cayetano Heredia, Peru

Ezzati, Majid:
 Imperial College London, United Kingdom

Danaei, Goodarz:
 Harvard T.H. Chan School of Public Health, United States

Aguilar-Salinas, Carlos A.:
 Instituto Nacional de Ciencias Médicas y Nutricion, Mexico

Alvarez-Vaz, Ramon:
 Universidad de la República, Uruguay

Amadio, Marselle B.:
 Centro Universitario Senac Santo Amaro, Brazil

Baccino, Cecilia:
 Universidad de la República, Uruguay

Bambs, Claudia:
 Pontificia Universidad Católica de Chile, Chile

Bastos, Joao Luiz:
 Universidade Federal de Santa Catarina, Brazil

Beckles, Gloria:
 Centers for Disease Control and Prevention, United States

Bernabe-Ortiz, Antonio:
 Universidad Peruana Cayetano Heredia, Peru

Bernardo C.D.:
 The University of Adelaide, Australia

Bloch, V, Katia:
 Universidade Federal do Rio de Janeiro (UFRJ), Brazil

Blumel, Juan E.:
 Universidad de Chile, Chile

Boggia, Jose G.:
 Universidad de la República, Uruguay

Borges, Pollyanna K.:
 Universidade Estadual de Ponta Grossa, Brazil

Bravo, Miguel:
 MELISA Institute, Chile

Brenes-Camacho, Gilbert:
 Universidad de Costa Rica, Costa Rica

Carbajal, Horacio A.:
 Universidad Nacional de la Plata, Argentina

Rascon M.S.C.:
 Universidad Nacional de Misiones, Argentina

Ceballos, Blanca H.:
 Hospital Dr Ramon Madariaga, Argentina

Colpani, Veronica:
 Federal University of Rio Grande do Sul, Brazil

Cooper, Jackie A.:
 Queen Mary University of London, United Kingdom

Cortes, Sandra:
 Pontificia Universidad Católica de Chile, Chile

Cortes-Valencia, Adrian:
 National Institute of Public Health, Mexico

Cunha, Roberto S.:
 Federal University of Espírito Santo, Brazil

D'Orsi, Eleonora:
 Universidade Federal de Santa Catarina, Brazil

Dow, William H.:
 University of California, Berkeley, United States

Espeche, Walter G.:
 Universidad Nacional de la Plata, Argentina

Fuchs, Flavio D.:
 Universidade Federal do Rio Grande do Sul, Brazil

Fuchs, Sandra C.:
 Universidade Federal do Rio Grande do Sul, Brazil

Gimeno, Suely G. A.:
 Universidad Federal de São Paulo, Brazil

Gomez-Velasco, Donaji:
 Instituto Nacional de Ciencias Médicas y Nutricion, Mexico

Gonzalez-Chica, David A.:
 The University of Adelaide, Australia

Gonzalez-Villalpando, Clicerio:
 Instituto Nacional de Salud Pública, Mexico

Gonzalez-Villalpando M.-E.:
 Centro de Estudios en Diabetes A.C., Mexico

Grazioli, Gonzalo:
 Hospital Churruca Visca, Argentina

Guerra, Ricardo O.:
 Federal University of Rio Grande do Norte, Brazil

Gutierrez, Laura:
 Institute for Clinical Effectiveness and Health Policy, Argentina

Herkenhoff, Fernando L.:
 Federal University of Espírito Santo, Brazil

Horimoto, Andrea R. V. R.:
 University of São Paulo, Brazil

Huidobro, Andrea:
 Universidad Católica del Maule, Chile

Koch, Elard:
 MELISA Institute, Chile

Lajous, Martin:
 National Institute of Public Health, Mexico

 Harvard T.H. Chan School of Public Health, United States

Lima-Costa, Maria Fernanda:
 Oswaldo Cruz Foundation, Brazil

Lopez-Ridaura, Ruy:
 National Institute of Public Health, Mexico

Maciel, Alvaro C. C.:
 Federal University of Rio Grande do Norte, Brazil

Manrique-Espinoza, Betty S.:
 National Institute of Public Health, Mexico

Marques, Larissa P.:
 Universidade Federal de Santa Catarina, Brazil

Mill, Jose G.:
 Federal University of Espírito Santo, Brazil

Moreira, Leila B.:
 Universidade Federal do Rio Grande do Sul, Brazil

Muñoz O.M.:
 Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Colombia

Ono, Lariane M.:
 Universidade Federal do Paraná, Brazil

Oppermann, Karen:
 Passo Fundo University, Brazil

Paiva, Karina M.:
 Universidade Federal de Santa Catarina, Brazil

Peixoto, V, Sergio:
 Oswaldo Cruz Foundation, Brazil

Pereira, Alexandre C.:
 University of São Paulo, Brazil

Peres, Karen G.:
 NDRIS/NDCS Duke-NUS Medical School, Singapore

Peres, Marco A.:
 NDRIS/NDCS Duke-NUS Medical School, Singapore

Ramirez-Palacios, Paula:
 IMSS Epidemiology and Health Services Research Unit, Mexico

Rech, Cassiano R.:
 Universidade Federal de Santa Catarina, Brazil

Rivera-Paredez, Berenice:
 National Autonomous University of Mexico, Mexico

Rodriguez, I, Nohora:
 Clinica de Marly, Colombia

Rojas-Martinez, Rosalba:
 Instituto Nacional de Salud Pública, Mexico

Rosero-Bixby, Luis:
 Universidad de Costa Rica, Costa Rica

Rubinstein, Adolfo:
 Institute for Clinical Effectiveness and Health Policy, Argentina

Ruiz-Morales, Alvaro:
 Pontificia Universidad Javeriana, Colombia

Salazar, Martin R.:
 Universidad Nacional de la Plata, Argentina

Salinas-Rodriguez, Aaron:
 National Institute of Public Health, Mexico

Salmeron, Jorge:
 National Autonomous University of Mexico, Mexico

Sanchez, Ramon A.:
 Universidad Nacional de Misiones, Argentina

Silva, Nelson A. S.:
 Universidade Federal do Rio de Janeiro (UFRJ), Brazil

Silva, Thiago L. N.:
 Universidade Federal do Rio de Janeiro (UFRJ), Brazil

Smeeth, Liam:
 London School of Hygiene & Tropical Medicine, United Kingdom

Spritzer, Poli M.:
 Federal University of Rio Grande do Sul, Brazil

Tartaglione, Fiorella:
 Hospital Churruca Visca, Argentina

Tartaglione, Jorge:
 Hospital Churruca Visca, Argentina

Velazquez-Cruz, Rafael:
 National Institute of Genomic Medicine (INMEGEN), Mexico
ISSN: 2667193X





LANCET REGIONAL HEALTH-AMERICAS
Editorial
Elsevier Ltd, RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS, Países Bajos
Tipo de documento: Article
Volumen: 4 Número:
Páginas:
WOS Id: 000894073800002
ID de PubMed: 34957436
imagen Green Published, Green Accepted, gold, Gold, Green